Georgia Highlands Medical Services, Inc., Cumming, GA

What do we offer?

• Health, Dental, Vision
• 11 Paid Holidays annually
• STD/LTD
• PTO accrual equal to 144hrs annually
• Friday half-days
• Life/ADD
• Tax Deferred Annuity with Corporate match up to 5%

Job description

Job Purpose

The Insurance-Billing Specialist is responsible for all issues related to billing and insurance, including the filing of all insurance claims, posting of all insurance plan payments, Explanation of Benefits (EOB) management, and the follow-up to all outstanding unpaid insurance claims. The Billing/Insurance Specialist also assists in the monthly patient statement billing process. This position will interact with insurance companies as well as patients. Coding experience in Family Practice Medicine a plus.

Duties and Responsibilities

• Work diligently to capture all charges due to Georgia Highlands Medical Services.
• Perform final scrubbing of all insured patient claims before submission to the payers to ensure accuracy and decrease denials from the payers as needed.
• Research and follow-up on all rejected claims by the clearinghouse.
• Correct any insurance issues that may affect the claims (reload insurance; ensure responsible party, DOB, eligibility, and patient’s name are all correct).
• Correct any CPT/ICD-10 problems for the claims as needed.
• Submit all insurance plan claims on a daily/weekly basis to ensure timely filing guidelines are met as needed.
• Research, verify, correct all insurance plan denials or unpaid claims in a timely manner. Contact insurance carrier and/or patient for resolution by utilizing an accurate tracking method for follow-up of unresolved claims.
• Communicate with providers to fix incorrect CPT/DX codes as needed.
• Resubmit all corrected claims as needed.
• Track unpaid claims to verify payment, and if not, why.
• Bill patients for non-covered charges as well as insurance denial balances on a weekly basis via patient statement transmissions through clearinghouse.
• Retrieve and handle all patient billing messages/calls from the Billing Line in a prompt manner.
• Work the aged A/R for account Bad Debt write-offs. Submit accounts to Collections; send letters to patients as needed.
• Post payments from insurance companies, both paper and EFT. Run report daily to verify totals.
• Run report for UDS and Financial Analysis.
• Follow Corporate, Ethical, and HIPAA policies and procedures to ensure the confidentiality of all patient information.
• Effectively practice teamwork, respect for coworkers, good attendance and punctuality. Properly request time off as needed per GHMS policies and procedures.
• Other duties as assigned to promote optimal healthcare to patients of GHMS.

Qualifications

Education / Experience

• High School graduate required
• 1-3 years’ experience in medical office billing or other financial work
• Experience with CPT/ICD-10 codes is a plus

Knowledge / Skills / Abilities

• Acute attention to detail to ensure all claim data is accurate. Highly organized.
• Working knowledge of medical terminology.
• Excellent Customer Service skills and professional manner when speaking with providers, insurance carriers, patients, etc.
• Knowledge of computer software, email, telephone system, word processing, spreadsheets, and EMR software.
• Excellent communication skills to include: active listening, reading comprehension, pleasant phone manner, and critical thinking.
• Working knowledge of computers, scanners, copiers, and fax machines.
• Experience of coding in Family Practice Medicine a plus.

Job Type: Full-time

COVID-19 considerations:
All patients and employees must wear face masks at all GHMS locations to help minimize the spread of COVID-19. All employees must be fully vaccinated against COVID-19.

Who is Georgia Highlands Medical Services?

• Community health center committed to offering high quality medical and behavioral health care to everyone in our service area – regardless of income level, insurance status or language spoken since 1979.
• Services we offer include counseling, psychiatry, family medicine, pediatrics, geriatrics, chiropractic, OB/GYN, and pharmacy services.
• 5 locations in North Georgia, including Cumming, Canton, Cartersville, and Dawsonville.
• Recognized by the National Committee for Quality Assurance (NCQA) as a Patient-Centered Medical Home.
• Our mission is to serve all people with compassion, dignity and integrity while providing excellent, affordable, and integrated health care.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

COVID-19 considerations:
All patients and employees must wear face masks at all GHMS locations to help minimize the spread of COVID-19. All employees must be fully vaccinated against COVID-19.

Application Question(s):

• Do you have Experience with Coding?

Education:

• High school or equivalent (Preferred)

Experience:

• Medical billing: 1 year (Required)
• Microsoft Excel: 1 year (Preferred)

Work Location: One location

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